READ- A Mobile Gaming Intervention to Increase Adherence to Antiretroviral Treatment for Youth Living With HIV: Development Guided by the Information, Motivation, and Behavioral Skills Model

Description of purpose:

It is estimated by the Centers for Disease Control and Prevention that teenagers aged 13-29 (41%) are infected with HIV infection; an estimated 99,463 in the United States adolescents are living with HIV and AIDS (CDC, 2016).

Antiretroviral treatment has improved the health of HIV-infected patients (Whiteley, 2018). If the adolescent adheres to treatment, it can decrease morbidity and mortality. Educating teenagers and intriguing them to adhere to treatment would be a challenge. 

Explanation of research design:

The study was based on developing an action-oriented iPhone gaming to improve adolescent adherence to antiretroviral medication and treatment. Twenty adolescents living with HIV were interviewed using qualitative interviews (Whiteley, 2018). 

Discussion of sample:

Twenty adolescents were recruited from a clinic in Rhode Island. The study used males and females 14 to 26 years old. Criteria must speak English, be in medical care for HIV and receive antiretroviral medications, be aware of their HIV status and clinical records, and be able to give consent of a parent/legal guardian if under 18 years old. 

Description of data collection methods:

A game app was developed called Battle Viro using an iPhone. Twenty adolescents were interviewed using a qualitative guide with the guide game development. The research staff used a board-approved flyer and written consent for the qualitative interviews. Eleven participants were shown the game's storyboard, nine were shown an interactive iPhone version, and feedback was to inform other game design and development (Whiteley, 2018). 

Summary of findings:

The game consists of playing a game with sound effects, graphing, and avatars that teach and remind them to take their medications. It showed what the medication does to their viral system, and researchers were able to monitor if adolescents were taking to their medication. The electronic pill monitoring organizer and game-related text messages to the researcher informing them of adherence. The game rewarded them with motivational words, and they were able to advance to the next level. The quantitative feedback was used by collecting adapted versions of the participant’s questionnaires and the session evaluation form, entering an excel program, and graded scale. 

Limitations of the study:

Teenagers were interviewed individually by a psychiatrist and a psychologist supported by trained researchers. Bi-weekly meetings were held to make game changes and improve participant feedback. The interviewed teenagers did not want the game to be named HIV adherence, and participants wanted informational game content that included new and comprehensive HIV details. 

The study was costly but successful. Limitation includes participants' recruitment from a single HIV clinic. The study should also focus on clinicians and caregivers in the game and include friends. Also, iPhone was used, but an Android device could allow more game availability. 

Recommendations regarding potential applications for future practice that are insightful and appropriate:

This study was mixed-method research. In this study, qualitative interviews focused on social learning theory to create an iPhone gaming intervention to measure and improve treatment adherence for HIV-infected adolescents and young adults. Teenagers and adolescents were motivated by this app. Teenagers are quickly bored, and this study showed stimulation and adherence improvement. Engaging them in video games reinforced skills and taught them evidence-based interventions that were patient-centered in a fun way.

I recommend apps like this. I believe this app benefits minorities with less access to medical care. Interventions like this empower and engage HIV teenagers and improve their health.

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